Systems and methods for coordinating musculoskeletal and cardiovascular hemodynamics

Abstract

Described herein are systems and methods for favorably coordinating a timing relationship between a musculoskeletal activity cycle and a cardiac cycle of a user. A method may include repetitively detecting a signal that correlates to a blood volume in the user; determining an actual value of the signal that varies with the timing relationship; computing a trend of the actual value of the signal; and adjusting the movement guidance based on the trend of the actual value. A system may include a prompt device configured to provide recurrently a movement guidance to the user for guiding performance of the rhythmic musculoskeletal activity; a sensor configured to provide a signal that correlates to a blood volume in the user; and a processor configured to determine an actual value of the signal that varies with the timing relationship and to adjust the movement guidance based on the trend of the actual value.

What is claimed is: 
     
       1. A method for achieving a favorable relative timing relationship between a rhythmic musculoskeletal activity cycle (MSKC) of a user and a cardiac cycle (CC) of the user, the method comprising:
 recurrently providing an output comprising a movement guidance from a prompt device to the user for guiding performance of a rhythmic musculoskeletal activity; and repetitively:
 detecting a signal that correlates to a cyclically-varying arterial blood volume in a tissue of the user; 
 determining, with a processor, a measured characteristic of the signal, which varies with adjustments to the timing relationship between the MSKC and the CC of the user, wherein the measured characteristic comprises at least one of: a measure of peak amplitude, a measure of average amplitude, a measure of peak to valley height, a measure of waveform complexity, and a modulation amplitude; 
 measuring, with the processor, an instantaneous behavior of the measured characteristic; 
 comparing, with the processor, the instantaneous behavior to a recent historical behavior of the measured characteristic over a given rolling window of time during performance of the rhythmic musculoskeletal activity; and 
 when the measured characteristic displays a trend relative to a local instantaneous or average maximum of the measured characteristic, automatically adjusting, with the processor, the movement guidance to move the user towards the local instantaneous or average maximum of the measured characteristic in order to achieve a hemodynamically more favorable timing relationship between the MSKC and the CC of the user. 
 
 
     
     
       2. The method of  claim 1 , wherein the movement guidance includes at least one of a recurrent audible, visual, or tactile prompt. 
     
     
       3. The method of  claim 2 , wherein a heart rate of the user is substantially an integer multiple of a rate of the prompt. 
     
     
       4. The method of  claim 1 , wherein detecting the signal comprises using as the sensor technology one of photoplethysmography, impedance plethysmography, laser-Doppler blood flow, acoustic sensing, and arterial tonometry. 
     
     
       5. The method of  claim 1 , further comprising:
 detecting, using one or more sensors, one or more signals that correlate to a heart rate of the user and a musculoskeletal activity cycle rate (MSKR) of the user; 
 determining, using the processor, the heart rate of the user and the MSKR of the user by processing the one or more signals; 
 specifying a maximum allowable absolute difference between the heart rate and the MSKR; and 
 executing, using the processor, steps of  claim 1  only when an absolute value of a difference between the MSKR and heart rate is less than, or less than or equal to, a specified allowable difference. 
 
     
     
       6. The method of  claim 5 , further comprising:
 specifying a target MSKR; and 
 recurrently providing the output from the prompt device when the absolute value of the difference between the MSKR and the target MSKR is greater, or greater than or equal to, the specified allowable difference, the output repeating at a prompt rate. 
 
     
     
       7. The method of  claim 6 , wherein the target MSKR is an integer multiple of the prompt rate. 
     
     
       8. The method of  claim 1 , wherein the movement guidance includes instructing the user in at least one of an MSK activity timing and an MSK activity effort. 
     
     
       9. The method of  claim 8 , wherein instructing the user in the MSK activity effort includes providing movement guidance on stride length during running or walking, gear use while riding a bicycle, resistance, MSKC movement distance or incline while using exercise equipment, or stroke length during rowing or swimming. 
     
     
       10. The method of  claim 8 , wherein instructing the user in the MSK activity timing includes providing a MSKC prompt at a prompt rate to guide the user to an MSKR that is an integer multiple of the prompt rate. 
     
     
       11. The method of  claim 1 , further comprising a calibration process, said calibration process comprising:
 detecting a second characteristic of at least one of the signal and one or more additional signals corresponding to a physiological metric that varies with the timing relationship between the MSKC and the CC of the user, using the sensor or one or more additional sensors; and 
 determining the relative maximum value of the measured characteristic as a relative value of the trend that corresponds with a preferred value of the physiological metric. 
 
     
     
       12. The method of  claim 11 , wherein the physiological metric comprises a measure of at least one of: a heart rate, a minute ventilation, a blood pressure, a blood flow, a cardiac output, an electrical brain activity, an oxygen consumption, a tissue pH, a tissue lactic acid level, or a CO 2  production. 
     
     
       13. The method of  claim 1 , wherein the measure of waveform complexity is at least one of: a measure of waveform smoothness and a measure of a degree to which the waveform is sinusoidal. 
     
     
       14. The method of  claim 1 , wherein the instantaneous behavior is one of: an increasing modulation amplitude, an increasing peak amplitude, an increasing average amplitude, a decreasing waveform complexity, and a change in timing of an aspect of the signal that repeats at a heart rate of the user. 
     
     
       15. A system for achieving a favorable relative timing relationship between a rhythmic musculoskeletal activity cycle (MSKC) of a user and a cardiac cycle (CC) of the user, the system comprising:
 a prompt device configured to provide recurrently an output comprising a movement guidance to the user for guiding performance of a rhythmic musculoskeletal activity; 
 a sensor configured to detect a signal that correlates to a cyclically-varying arterial blood volume in a tissue of the user; and 
 a processor, coupled to the prompt device and the sensor, wherein the processor is configured to:
 determine a measured characteristic of the signal, which varies with adjustments to the timing relationship between the MSKC and the CC of the user, wherein the measured characteristic comprises at least one of: a measure of peak amplitude, a measure of average amplitude, a measure of peak to valley height, a measure of waveform complexity, and a modulation amplitude, 
 measure, with the processor, an instantaneous behavior of the measured characteristic, 
 compare, with the processor, the instantaneous behavior to a recent historical behavior of the measured characteristic over a given rolling window of time during performance of the rhythmic musculoskeletal activity, and 
 when the measured characteristic displays a trend relative to a local instantaneous or average maximum of the measured characteristic, automatically adjust, with the processor, the movement guidance to move the user towards the local instantaneous or average maximum of the measured characteristic in order to achieve a hemodynamically more favorable timing relationship between the MSKC and the CC of the user. 
 
 
     
     
       16. The system of  claim 15 , wherein the sensor technology includes one of photoplethysmography, impedance plethysmography, laser-Doppler blood flow, acoustic sensing, and arterial tonometry. 
     
     
       17. A method for achieving a favorable relative timing relationship between a rhythmic musculoskeletal activity cycle (MSKC) of a user and a cardiac cycle (CC) of the user, the method comprising:
 repetitively:
 detecting a signal responsive to cyclically-varying arterial blood volume in a tissue of the user using a sensor; 
 determining, with a processor, a first measured characteristic of the signal that repeats at a heart rate (HR) of the user and determining the HR of the user from the first measured characteristic; 
 recurrently providing an output comprising a guidance prompt from a prompt device to the user as a timing indication for performance of a rhythmic musculoskeletal activity, wherein the guidance prompt is timed such that the HR is an integer multiple of a rate of the guidance prompt; 
 determining, with a processor, a second measured characteristic of the signal, which varies with an actual MSKC to CC timing relationship of the user, wherein the second measured characteristic comprises at least one of: a measure of peak amplitude, a measure of average amplitude, a measure of peak to valley height, a measure of waveform complexity, and a modulation amplitude; 
 measuring, with the processor, an instantaneous behavior of the second measured characteristic; 
 comparing, with the processor, the instantaneous behavior to a recent historical behavior of the second measured characteristic over a given rolling window of time during performance of the rhythmic musculoskeletal activity; and 
 when the second measured characteristic displays a trend relative to a local instantaneous or average maximum of the second measured characteristic, automatically adjusting, with the processor, the guidance prompt to move the user towards the local instantaneous or average maximum of the second measured characteristic in order to achieve a hemodynamically more favorable MSKC to CC timing relationship. 
 
 
     
     
       18. The method of  claim 17 , further comprising detecting the MSKC of the user using the sensor or a second sensor. 
     
     
       19. The method of  claim 18 , wherein the second sensor is one of: an accelerometer, an electromyographic sensor, a pressure sensor, a switch, a camera, a gryroscope, a proximity sensor, and a plethysmographic sensor. 
     
     
       20. The method of  claim 17 , wherein the cyclically-varying arterial blood volume oscillates in magnitude between a maximal size and a minimal size at a rate equal to a difference between the HR and a rate of performance of the rhythmic musculoskeletal activity. 
     
     
       21. The method of  claim 17 , wherein the instantaneous behavior of the second measured characteristic is one of: an increasing modulation amplitude, an increasing peak amplitude, an increasing average amplitude, a decreasing waveform complexity, and a change in timing of an aspect of the signal that repeats at the HR of the user.